Numerous publications and patent documents, including both published applications and issued patents, are cited throughout the specification in order to describe the state of the art to which this invention pertains. Each of these citations is incorporated herein by reference as though set forth in full.
Eosinophilic esophagitis (EoE) is an inflammatory disorder of the esophagus histologically characterized by accumulation of eosinophils in the esophageal epithelium. Clinical symptoms of EoE include dysphagia, failure to thrive, vomiting and epigastric or chest pain. A diagnosis of EoE is made following endoscopy and biopsy upon finding isolated eosinophils in the esophagus having ruled out gastroesophageal reflux. Multiple reports indicate a gender bias, with males predominantly affected. The rate of co-existing atopic disease in other organs is high, with up to 70% of subjects presenting with asthma or atopic dermatitis. EoE is considered a food allergy-related disorder based on the high rate of food allergen sensitization and a higher rate of food anaphylaxis in cases compared with the general population. Furthermore, the majority of EoE cases undergo disease remission following introduction of an elemental formula diet that lacks allergens. Experimental modeling of EoE in mice has demonstrated a key role for adaptive immunity and Th2-cell cytokines (especially IL-5 and IL-13) in the disease process and a strong connection between allergic sensitization and inflammation in the respiratory tract and skin. EoE is inherited as a complex trait suggesting it is caused by multiple genetic variations interacting with environmental influences. Clearly, a need exists in the art for improved methods for diagnosis and management of this disorder.